[Evaluation of MIA syndrome in peritoneal dialysis patients].
BACKGROUND
The MIA syndrome plays a key role as it, including a set of traditional risk and other factors affects prognosis in peritoneal dialysis patients. Many epidemiological studies showed that the type of peritoneal transport clearly correlated with the level of serum albumins. Increased transport is associated with low serum albumin levels, as well as a high level of CRP. They are correlated with a poor prognosis in patients with renal failure. The aim of the study was to assess the role of the MIA syndrome in patients at the beginning of peritoneal dialysis treatment.


METHODS
We examined 61 patients at the beginning of peritoneal dialysis (age 61.93+/-8.30 years), 10 patients had diabetic nephropathy. MIA syndrome was measured by the scoring system and correlated with standard promoters used in the peritoneal equilibration test (PET). The patients were classified in three groups. We were monitoring acute-phase reactions, biochemical measures of the nutritional status and the loss of proteins.


RESULTS
Patients with a malnutrition score of 10-20 (group II) were observed in terms of the urine volume. 17 patients were between 100 and 1000 ml and only 9 patients had urine volume lower then 100 ml. 8 patients had diabetic nephropathy. 35 patients had significantly higher values of albumin, CRP and transferrin (ANOVA: p<0.05). We also discovered a higher death rate (28.6%) as well as early weekly creatinine clearance (H and HA transport type) and measured that the concentration of glucose D/D0 was significantly elevated. An excessive loss of proteins through the peritoneal membrane was also present.


CONCLUSIONS
Peritoneal membrane remodeling is a big problem and it is important to be monitaed. However, we suggest that the early evaluation of the MIA syndrome was an independent predictor of the outcome.
Tasić
Danijela
D
Institut za nefrologiju i hemodijalizu, Klinicki centar, Nis. danijeladt@yahoo.com
D000368:Aged; D050197:Atherosclerosis / Q000150:complications / Q000175:diagnosis*; D002097:C-Reactive Protein / Q000032:analysis; D006801:Humans; D007249:Inflammation; D018836:Inflammation Mediators / Q000097:blood*; D044342:Malnutrition / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010537:Peritoneum / Q000378:metabolism; D012709:Serum Albumin / Q000032:analysis; D013577:Syndrome
D018836:Inflammation Mediators; D012709:Serum Albumin; D002097:C-Reactive Protein